Question to the Department for Transport:

To ask the Secretary of State for Transport, what steps she is taking to ensure there are sufficient rail services on alternative routes when planned maintenance works cause the closure of lines.

Answered by Keir Mather - Parliamentary Under-Secretary (Department for Transport)

Network Rail plans its timetables 12 months in advance, meaning it can schedule in the time needed for planned works to improve the network. Network Rail plan works that cause the least disruption to passengers and include Bank Holidays, Sundays, and overnight when the network is less busy.

However, when planned engineering works necessitate the closure of lines, train operating companies provide alternative transport and travel arrangements to help passengers complete their journeys. Alternative transport provision may include rail replacement services, ticket acceptance on other routes/operators, or diverted trains.

Question to the Cabinet Office:

To ask the Minister for the Cabinet Office, pursuant to the Answer of 21 November 2025 to Question 91601 on Prime Minister: Climate Change Convention, on what basis possibility is assessed in respect of publishing offsetting data.

Answered by Nick Thomas-Symonds - Paymaster General and Minister for the Cabinet Office

Prime Ministerial flights are carbon offset where that is possible. This takes into account a range of factors. GBNI flights are carbon offset at the end of the financial year. Information about official overseas travel is published as part of the Cabinet Office transparency returns and made available on the GOV.UK website, in line with the approach of successive administrations.

Question to the HM Treasury:

To ask the Chancellor of the Exchequer, how many new enquiries were opened into child benefit claims which were suspended from claimants as a result of data-sharing between HMRC and the Home Office in the period 1st to 30th November 2025.

Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)

There were no new Child Benefit compliance enquiries opened using Home Office international travel data in the period 1st to 30th November 2025. This is because our focus during that time was on reviewing the c. 23,500 already opened.

Question to the HM Treasury:

To ask the Chancellor of the Exchequer, if she will make an estimate of how many businesses in the Fylde constituency will be impacted by the pay per mile tax on electric and hybrid cars.

Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)

As announced at Budget 2025, the Government is introducing Electric Vehicle Excise Duty (eVED) from April 2028, a new mileage charge for electric and plug-in hybrid cars, recognising that EVs contribute to congestion and wear and tear on the roads but pay no equivalent to fuel duty.

When eVED takes effect in April 2028, eVED rates will be set at 3p per mile for electric vehicles, which is half the equivalent fuel duty rate paid by the average petrol/diesel driver, ensuring that driving an electric vehicle continues to be an attractive choice for consumers. The rate will be set at 1.5p per mile for plug-in hybrids, recognising that they will continue to pay fuel duty on miles driven in petrol mode. An average EV driver driving 8,000 miles per year will pay around £240 per year or £20 per month.

As set out by the OBR, the estimated net impact of eVED and other Budget measures, including the ECG and ECS, is 120,000 fewer new EV sales across the forecast period. This is against a baseline which assumes EV sales more than triple from 2025-26 levels by 2030-31, which means the net impact of eVED represents only 2% of total new EV sales in the period.

The Government has set out expected impacts from eVED and other Budget measures in the Budget 2025 Policy Costings document at GOV.UK: https://assets.publishing.service.gov.uk/media/692872fd2a37784b16ecf676/Budget_2025-Policy_Costings.pdf

Question to the HM Treasury:

To ask the Chancellor of the Exchequer, if she will make an estimate of the impact of the pay per mile tax on electric vehicle usage in the Fylde constituency.

Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)

As announced at Budget 2025, the Government is introducing Electric Vehicle Excise Duty (eVED) from April 2028, a new mileage charge for electric and plug-in hybrid cars, recognising that EVs contribute to congestion and wear and tear on the roads but pay no equivalent to fuel duty.

When eVED takes effect in April 2028, eVED rates will be set at 3p per mile for electric vehicles, which is half the equivalent fuel duty rate paid by the average petrol/diesel driver, ensuring that driving an electric vehicle continues to be an attractive choice for consumers. The rate will be set at 1.5p per mile for plug-in hybrids, recognising that they will continue to pay fuel duty on miles driven in petrol mode. An average EV driver driving 8,000 miles per year will pay around £240 per year or £20 per month.

As set out by the OBR, the estimated net impact of eVED and other Budget measures, including the ECG and ECS, is 120,000 fewer new EV sales across the forecast period. This is against a baseline which assumes EV sales more than triple from 2025-26 levels by 2030-31, which means the net impact of eVED represents only 2% of total new EV sales in the period.

The Government has set out expected impacts from eVED and other Budget measures in the Budget 2025 Policy Costings document at GOV.UK: https://assets.publishing.service.gov.uk/media/692872fd2a37784b16ecf676/Budget_2025-Policy_Costings.pdf

Question to the HM Treasury:

To ask the Chancellor of the Exchequer, if she has make an assessment of the potential impact of reforming business rates on small pubs and breweries.

Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)

In April 2026, the Government will introduce permanently lower business rates multipliers for retail, hospitality, and leisure (RHL) properties with rateable values below £500,000. This permanent tax cut will ensure that eligible properties, including pubs, benefit from much-needed certainty and support. Breweries that are wholly or mainly open to visiting members of the public (for instance, mainly used as a bar or for providing tours to the public) will also benefit from the lower multipliers.

The final design, including the rates, for the new business rates multipliers will be announced at Budget 2025, so that the Government can factor the revaluation outcomes, as well as the broader economic and fiscal context, into decision-making. When the new multipliers are set, HM Treasury intends to publish analysis of the effects of the new multiplier arrangements.

Ahead of the new multipliers being introduced, the Government prevented RHL business rates relief from ending in April 2025, extending it for one year at 40 per cent up to a cash cap of £110,000 per business. Under the previous Government, RHL relief was due to end entirely in April 2025, and so by extending it, the Government has saved the average pub, with a ratable value of £16,800, over £3,300.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what data his Department holds on the prevalence of cleft palate syndrome in the UK; and what steps his Department is taking to raise awareness among (a) healthcare professionals and (b) the general public.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

The Cleft Registry and Audit Network (CRANE) is a national register and clinical audit funded by NHS England to evaluate and report on the delivery of cleft services to children born with a cleft lip and/or palate in England, Wales, Northern Ireland, and Scotland. The 2024 Annual Report states that cleft lip and/or palate is a common condition, affecting one in 660 births and between 2021 and 2023, as 2,609 children were registered on CRANE, which is approximately 870 per year.

As part of their development activities, CRANE has previously linked with national educational data in England and found that attainment gaps exist between those with a cleft and the general population.

The Department, through the National Institute for Health and Care Research (NIHR), is currently funding a £2 million study to improve outcomes for individuals with cleft lip and/or palate by addressing variation in unmet needs.

This study aims to understand, and subsequently develop a tool to help address, the clinical, psychosocial, educational, and patient-reported needs of young adults with cleft lip and/or palate when they move from child to adult health services.

The NIHR continues to welcome funding applications for research into any aspect of human health, including cleft palate.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what information his Department holds on the long-term (a) health, (b) educational and (c) social outcomes of individuals born with cleft palate syndrome; and what steps his Department is taking to monitor these outcomes.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

The Cleft Registry and Audit Network (CRANE) is a national register and clinical audit funded by NHS England to evaluate and report on the delivery of cleft services to children born with a cleft lip and/or palate in England, Wales, Northern Ireland, and Scotland. The 2024 Annual Report states that cleft lip and/or palate is a common condition, affecting one in 660 births and between 2021 and 2023, as 2,609 children were registered on CRANE, which is approximately 870 per year.

As part of their development activities, CRANE has previously linked with national educational data in England and found that attainment gaps exist between those with a cleft and the general population.

The Department, through the National Institute for Health and Care Research (NIHR), is currently funding a £2 million study to improve outcomes for individuals with cleft lip and/or palate by addressing variation in unmet needs.

This study aims to understand, and subsequently develop a tool to help address, the clinical, psychosocial, educational, and patient-reported needs of young adults with cleft lip and/or palate when they move from child to adult health services.

The NIHR continues to welcome funding applications for research into any aspect of human health, including cleft palate.

Question to the Department for Business and Trade:

To ask the Secretary of State for Business and Trade, what recent assessment he has made of the potential impact of Government support schemes on small business participation in Small Business Saturday.

Answered by Blair McDougall - Parliamentary Under Secretary of State (Department for Business and Trade)

I congratulate Small Business Britain on another excellent Small Business Saturday, during which the Government launched the new ‘Backing your Business’ campaign to drive uptake of the Business Growth Service and boost awareness of the Small Business Plan. We have been delivering on our promise to back SMEs across Britain.

This includes work to tackle late payments and cut the administrative costs of regulation saving SME owners time and money so they can focus on running successful businesses and continue to participate in important campaigns such as Small Business Saturday.

Question to the Department for Business and Trade:

To ask the Secretary of State for Business and Trade, what recent assessment his Department has made of the economic impact of Small Business Saturday on high streets and local economies.

Answered by Blair McDougall - Parliamentary Under Secretary of State (Department for Business and Trade)

The Department has not done, and does not plan to do an assessment of the economic impact of Small Business Saturday on high streets and local economies.

The Small Business Saturday campaign has done its own analysis; they suggest that Small Business Saturday could deliver a £5 billion boost for the sector. The Department has also launched its Backing Your Business campaign, designed to raise awareness of the support being provided to SMEs within the Small Business Plan, including on high streets and local economies.

Question to the Department for Environment, Food and Rural Affairs:

To ask the Secretary of State for Environment, Food and Rural Affairs, what assessment she has made of the adequacy of water infrastructure.

Answered by Emma Hardy - Parliamentary Under-Secretary (Department for Environment, Food and Rural Affairs)

A record £104 billion of investment is planned for the water sector in the next investment cycle. This will provide the water supply and wastewater capacity to secure future water supplies, including nine new reservoirs and several large-scale water transfer schemes.

Question to the Home Office:

To ask the Secretary of State for the Home Department, how many illegal immigrants have been deported under the Dublin Convention.

Answered by Alex Norris - Minister of State (Home Office)

The Home Office publishes data on asylum in the ‘Immigration System Statistics Quarterly Release’. Data on the number of individuals transferred out of the UK under the Dublin regulation is published in the Dublin regulation detailed dataset (Dub_D01). Information on how to use the dataset can be found in the ‘Notes’ page of the workbook. The data relates up to the end of 2020, after which the UK was no longer subject to the Dublin regulation.

Question to the HM Treasury:

To ask the Chancellor of the Exchequer, what assessment she has made of the effectiveness of the online Self Assessment Time to Pay system in reducing the number of late payment penalties.

Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)

HMRC’s Time to Pay (TTP) arrangements help taxpayers to pay their liabilities in affordable and sustainable instalments. Late payment penalties do not apply provided the plan is agreed before penalty trigger dates and instalments are paid on time.

HMRC’s online TTP service for Self Assessment offers taxpayers the option to set up their own payment plans for Self Assessment debts up to £30,000. HMRC publishes data on TTP arrangements as part of its quarterly performance updates and in its Annual Report and Accounts. Over 90% of TTP arrangements are completed successfully, demonstrating their effectiveness in supporting compliance and reducing penalties.

Question to the Cabinet Office:

To ask the Minister for the Cabinet Office, how much funding was allocated to the Civil Service LGBT Plus Network in each of the last five years.

Answered by Anna Turley - Minister without Portfolio (Cabinet Office)

I refer you to the response given by Minister Gould to PQ43014 in April of this year which asked what the cost to the public purse was of this employee network.

The Civil Service LGBT+ staff network is a volunteer collaborative group of Civil Service staff. The LGBT+ network does not hold a budget, but a department can choose to provide support where there is a business case to do so. We are not aware of any such financial support. There has been no cost to the public purse of the LGBT+ network since 2020. We do not hold any records prior to this date. The LGBT+ network was created in 2003.

Question to the Department for Education:

To ask the Secretary of State for Education, what recent discussions she has had with school governing bodies on improving transparency for parents.

Answered by Georgia Gould - Minister of State (Education)

The department’s governance guidance for schools and trusts makes clear that as publicly funded organisations, schools and trusts should foster a culture of transparency and welcome public scrutiny.

When shaping the school or trust’s vision, the governing body or trust board should remain connected and responsive to pupils, staff, parents, carers, and the wider community through meaningful engagement.

To promote transparency in decision-making, the governing body or trust board should actively seek and consider the views of parents and carers. Governing bodies and trust boards are required to have at least two parent governors/trustees.

To ensure transparency, details of governors/trustees are recorded on Get Information About Schools, and governance structures, governor/trustee register of pecuniary of interests and governance meeting attendance are published on the school’s or trust’s website.

Question to the HM Treasury:

To ask the Chancellor of the Exchequer, what engagement she undertook with the pub and hospitality sector ahead of the 2025 Budget, particularly in the context of Business Rates.

Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)

Treasury Ministers and officials engaged with a wide range of stakeholders across the pub and hospitality sector ahead of the Budget to discuss business rates.

We continue to engage with the hospitality sector to understand the pressures they face.

Question to the Department for Education:

To ask the Secretary of State for Education, what assessment she has made of the consistency of pupil experience between Key Stage 1 and Key Stage 2; and what steps she is taking to address declines in pupil motivation or engagement during the transition between these stages.

Answered by Georgia Gould - Minister of State (Education)

The department recognises that moving between key stages can be challenging for some children, including the transition from key stage 1 to key stage 2.

One of the ways the department is looking to understand the experiences of children is through our Educational Outcome Pathways Studies (EOPS). EOPS Primary follows children in primary school from years 1 through 6 and collects data on their experiences, progress at school and wellbeing. It also examines factors at home, at school and in the wider environment that may influence children’s attitudes, behaviours and outcomes. Children in the study are currently in year 3, which is the key stage 2 transition year.

Alongside this, the government has committed to publish a new pupil engagement framework, helping schools to identify and address aspects of the pupil experience in their setting which may be preventing children from attending, achieving and thriving. As it is developed, we will consider the evidence around effective practice that supports pupil transitions alongside other approaches that can support pupil engagement.

Question to the Department for Digital, Culture, Media & Sport:

To ask the Secretary of State for Culture, Media and Sport, what recent discussions she has had with regional leaders on supporting tourism growth outside London.

Answered by Stephanie Peacock - Parliamentary Under Secretary of State (Department for Culture, Media and Sport)

DCMS is committed to ensuring that tourism contributes to growth and jobs across all parts of the country and particularly in coastal areas including Fylde, home to attractions including Lytham St Annes and the historic Lytham Hall.

A number of regional leaders are represented in the joint industry and Government-led Visitor Economy Advisory Council, which I co-chair. In this way, the views of regional leaders help to inform and shape Government policy. The Council is also helping to deliver the forthcoming sector growth plan which will set out a long term plan to increase visitor flows across the UK, boost value, and deliver sustainable growth.

The Lancashire Local Visitor Economy Partnership (LVEP), which includes the constituency of Fylde, works collaboratively with both local authority and private sector partners to communicate investment opportunities and to showcase Lancashire’s strengths as a place to live, work, study and invest in, as well as a premier destination for visitors.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that the digital social care record system is designed and maintained to national security standards.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

The Department has not designed a single digital social care record (DSCR) system. Rather, through the Digitising Social Care (DiSC) programme which ended in April 2025, the Government set standards for DSCRs and created a list of solutions that have been assured against those key standards and capabilities. This includes data, cybersecurity, and interoperability standards. There are now 21 assured solutions on the list. In partnership with NHS England, the Department has driven the adoption of DSCRs to 80% of Care Quality Commission registered care providers, benefiting 89% of people who draw on care.

Most, but not all, care providers are using assured DSCRs. Building on the work of the DiSC programme, we have set an ambition for all care providers to be fully digitised by the end of this Parliament. A fully digitised care provider is a registered care provider that uses an assured DSCR and meets national data security standards as set out through the Data Security and Protection Toolkit. These standards protect people’s sensitive information and make sure systems can connect safely and securely across health and social care.

In January 2025, the Department announced that it is investing in a new national data infrastructure for social care. This will lay the foundations for near real-time visibility of information from adult social care, such as DSCRs, and health care services. Data protection, privacy, and transparency, as well as the ethical use of data, will be central to the design of the infrastructure.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether NHS England audits the use of DNR notices in cases involving vulnerable adults.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England does not audit the use of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions in cases involving vulnerable adults. However, the Learning from Lives and Deaths Review (LeDeR) includes questions on the quality and content of DNACPR records. The review supports local service improvement and has been running for several years.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department plans to publish yearly progress reports on the implementation of the Single Patient Record.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department and NHS England will be monitoring the implementation of the single patient record and will provide regular updates on progress.

Question to the Department for Digital, Culture, Media & Sport:

To ask the Secretary of State for Culture, Media and Sport, pursuant to the answer of 13 November 2025 to question 90762 on BBC: Royal Charters, what assessment she has made of the potential impact of perceived bias in the programme Question Time on the priorities of the new BBC Royal Charter.

Answered by Ian Murray - Minister of State (Department for Science, Innovation and Technology)

The BBC is editorially and operationally independent from the Government and this is a crucial component of why people trust it. Under its Royal Charter, the BBC has a duty to deliver impartial and accurate news coverage and content, and the Government expects the BBC to uphold these standards.

It is then for Ofcom, as the independent regulator, to ensure the BBC is fulfilling its obligations to audiences, including on impartiality and accuracy, as outlined in the Charter.

The forthcoming Charter Review will provide an opportunity for the Government to consider a range of issues and to set the BBC up for success long into the future.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what discussions his Department has had with (a) NHS England and (b) local authorities on coordinating social care for people with overlapping illnesses.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

The Department is working with NHS England and the Local Government Association to co-develop a National Framework for Neighbourhood Health Plans. This framework will outline how the National Health Service, local authorities, and other partners should work together under the leadership of health and wellbeing boards to design neighbourhood health services for different population cohorts.

The Better Care Fund (BCF) is a framework for integrated care boards and local authorities to make joint plans and pool budgets for integrated health and care. From 2026/27, the BCF will be reformed to ensure consistent joint funding for services that are essential for integrated health and social care, especially for those with complex health and care needs.

People with the most complex needs may be eligible for NHS Continuing Healthcare (CHC), an NHS-funded package of health and social care for individuals assessed as having a 'primary health need'. CHC guidance states that integrated care boards must consult with the local authority, as far as reasonably practicable, when assessing eligibility for CHC.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, with reference to the Child Poverty Strategy, published on 5 December 2025, what interim milestones will be used to track progress toward lifting 550,000 children out of poverty by the end of the Parliament.

Answered by Diana Johnson - Minister of State (Department for Work and Pensions)

The Monitoring and Evaluation Framework, published alongside the Strategy, sets out how we will track progress and evaluate success as part of our ongoing commitment to transparency, accountability and continued learning.

We will use two complementary headline metrics, relative low income (after housing costs) and deep material poverty, as well as a comprehensive programme of analysis focusing on the drivers of child poverty and the impact of specific interventions.

The Monitoring and Evaluation framework set out that a baseline report will be published in Summer 2026, reflecting the further development of plans and updated findings from the latest poverty statistics publications, with annual reporting on progress thereafter.

Question to the Department for Transport:

To ask the Secretary of State for Transport, pursuant to the Answer of 20 Oct 2025 to Question 81532 on Taxis: Licensing, what assessment she has made of the adequacy of the powers available to local licensing authorities for ensuring the effective enforcement of private-hire vehicles that are licensed in one authority but predominantly operate in another.

Answered by Lilian Greenwood - Government Whip, Lord Commissioner of HM Treasury

The Department for Transport is legislating to tackle inconsistent standards of taxi and private hire vehicle licensing. The English Devolution and Community Empowerment Bill would enable the setting of national minimum standards in licensing.

We are considering further options including in relation to out of area working and enforcement powers. In the interim, as recommended in the Department’s guidance to licensing authorities in England, enforcement officers should be jointly authorised by authorities where there is a need. The guidance also highlights that licensing authorities can seek further powers from their local police chief constables under the Community Safety Accreditation Scheme (CSAS).

Question to the Department for Education:

To ask the Secretary of State for Education, what assessment she has made of the potential impact of early language intervention on educational outcomes for deaf children.

Answered by Olivia Bailey - Parliamentary Under-Secretary of State (Department for Education) (Equalities)

Every child deserves the best start in life, including those who are deaf or hard of hearing. Early language skills at age five strongly predict future academic success, and timely access to specialist support is critical.

From April 2026, funding for home learning environment and parenting support within Best Start Family Hubs will focus on evidence-based interventions for 3-4-year-olds, including Auditory Verbal Therapy, for children who are deaf or use hearing technology.

The department funds proven programmes like the Nuffield Early Language Intervention which improves oral language and literacy. Independent evaluation found children made four months’ additional progress, rising to seven months for those eligible for free school meals. Whilst not a substitute for specialist therapy, many children benefit from such interventions, including some deaf children. We have also updated the early years foundation stage profile handbook, ensuring children can use their preferred mode of communication, such as signing, across all early learning goals.

Alongside this, the Early Language Support for Every Child programme trials new approaches to identify and support speech, language, and communication needs, with evaluation due autumn 2026.

Question to the Cabinet Office:

To ask the Minister for the Cabinet Office, what guidance has been issued to help civil servants distinguish between acceptable network activity and activity that may breach impartiality rules.

Answered by Anna Turley - Minister without Portfolio (Cabinet Office)

The Staff Network Policy was launched on 23 September 2025 and is applicable to all cross-Civil Service Staff networks, from this date. Departments have been strongly encouraged to adopt or align to this policy for their own departmental networks. The policy establishes a consistent framework to ensure all staff networks operate effectively, in line with the Civil Service code.

Question to the HM Treasury:

To ask the Chancellor of the Exchequer, what recent discussions she has had with the brewing and pub sector on business rates affordability following the November Budget.

Answered by Dan Tomlinson - Exchequer Secretary (HM Treasury)

The amount of business rates paid on each property is based on the rateable value of the property, assessed by the Valuation Office Agency (VOA), and the multiplier values, which are set by the Government. Rateable values are re-assessed every three years. Revaluations ensure that the rateable values of properties (i.e. the tax base) remain in line with market changes, and that the tax rates adjust to reflect changes in the tax base.

At the Budget, the VOA announced updated property values from the 2026 revaluation. This revaluation is the first since Covid, which has led to significant increases in rateable values for some properties as they recover from the pandemic. To support with bill increases, at the Budget, the Government announced a support package worth £4.3 billion over the next three years, including protection for ratepayers seeing their bills increase because of the revaluation. As a result, over half of ratepayers will see no bill increases, including 23% seeing their bills go down. This means most properties seeing increases will see them capped at 15% or less next year, or £800 for the smallest.

More broadly, the Government is delivering a long overdue reform to rebalance the business rates system and support the high street, as promised in our manifesto.

The Government is doing this by introducing new permanently lower tax rates for eligible retail, hospitality and leisure (RHL) properties. These new tax rates are worth nearly £900 million per year, and will benefit over 750,000 properties, including those on the high street.

The new RHL tax rates replace the temporary RHL relief that has been winding down since Covid. Unlike RHL relief, the new rates are permanent, giving businesses certainty and stability, and there will be no cap, meaning all qualifying properties on high streets across England will benefit.

Treasury Ministers and officials engaged with a wide range of stakeholders across the pub and hospitality sector ahead of the Budget to discuss business rates.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether (a) families and (b) attorneys holding Power of Attorney are notified immediately when a DNR notice is added to a vulnerable adult’s medical record.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department remains clear that it is unacceptable for Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions to be applied in a blanket fashion to any group of people and should be fully discussed with the individual and their family where possible and appropriate. NHS England clinical leaders have issued a number of statements and letters to health and care providers which emphasise personalised approaches to care and treatment and which reiterate that there has never been an instruction or directive issued by the National Health Service to put in place a DNACPR solely on the basis of disability, learning disability, or special needs.

Agreement to a DNACPR is an individual decision and should involve the person concerned or, where the person lacks capacity, their families, carers, guardians, or other legally recognised advocates. Guidance from clinical bodies such as the British Medical Association, the Resuscitation Council UK, and Royal College of Nursing reflects this. These decisions should take into account the patient’s wishes, or those of people close to the patient, informed by a sensitive explanation of the risks and burdens associated with giving cardiopulmonary resuscitation. The treating doctor should try to reach agreement with the patient or those close to the patient. If, after discussion, the doctor remains of the view that cardiopulmonary resuscitation would not be clinically appropriate, there is not an obligation to attempt it. However, the rationale for not doing so should be clearly articulated. NHS England has published public-facing guidance on DNACPR decisions on the NHS.UK website. This includes advice on asking for a second opinion or review if patients, or their families, disagree with a DNACPR decision.

The Department has not received any complaints regarding DNACPR decisions being applied without consent in the last five years.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether guidance has been issued to NHS Trusts to ensure that DNR decisions are never made solely on the basis of disability, learning disability and special needs.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department remains clear that it is unacceptable for Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions to be applied in a blanket fashion to any group of people and should be fully discussed with the individual and their family where possible and appropriate. NHS England clinical leaders have issued a number of statements and letters to health and care providers which emphasise personalised approaches to care and treatment and which reiterate that there has never been an instruction or directive issued by the National Health Service to put in place a DNACPR solely on the basis of disability, learning disability, or special needs.

Agreement to a DNACPR is an individual decision and should involve the person concerned or, where the person lacks capacity, their families, carers, guardians, or other legally recognised advocates. Guidance from clinical bodies such as the British Medical Association, the Resuscitation Council UK, and Royal College of Nursing reflects this. These decisions should take into account the patient’s wishes, or those of people close to the patient, informed by a sensitive explanation of the risks and burdens associated with giving cardiopulmonary resuscitation. The treating doctor should try to reach agreement with the patient or those close to the patient. If, after discussion, the doctor remains of the view that cardiopulmonary resuscitation would not be clinically appropriate, there is not an obligation to attempt it. However, the rationale for not doing so should be clearly articulated. NHS England has published public-facing guidance on DNACPR decisions on the NHS.UK website. This includes advice on asking for a second opinion or review if patients, or their families, disagree with a DNACPR decision.

The Department has not received any complaints regarding DNACPR decisions being applied without consent in the last five years.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many complaints his Department has received in each of the last five years regarding DNR notices being applied without consent.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The Department remains clear that it is unacceptable for Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions to be applied in a blanket fashion to any group of people and should be fully discussed with the individual and their family where possible and appropriate. NHS England clinical leaders have issued a number of statements and letters to health and care providers which emphasise personalised approaches to care and treatment and which reiterate that there has never been an instruction or directive issued by the National Health Service to put in place a DNACPR solely on the basis of disability, learning disability, or special needs.

Agreement to a DNACPR is an individual decision and should involve the person concerned or, where the person lacks capacity, their families, carers, guardians, or other legally recognised advocates. Guidance from clinical bodies such as the British Medical Association, the Resuscitation Council UK, and Royal College of Nursing reflects this. These decisions should take into account the patient’s wishes, or those of people close to the patient, informed by a sensitive explanation of the risks and burdens associated with giving cardiopulmonary resuscitation. The treating doctor should try to reach agreement with the patient or those close to the patient. If, after discussion, the doctor remains of the view that cardiopulmonary resuscitation would not be clinically appropriate, there is not an obligation to attempt it. However, the rationale for not doing so should be clearly articulated. NHS England has published public-facing guidance on DNACPR decisions on the NHS.UK website. This includes advice on asking for a second opinion or review if patients, or their families, disagree with a DNACPR decision.

The Department has not received any complaints regarding DNACPR decisions being applied without consent in the last five years.